The invention relates to a needle holder with ligature scissors.
Needle holders especially for endoscopic operations are known in the art. In DE 41 27 812 C2 there is described a needle holder with a forceps-shaped tool part and a scissor grip type handle part. From EP 0 437 063 B1 there is known a needle holder which additional to the actual holding function also automatically effects an alignment of the needle in a defined position, thus apart from the holding function it fulfills also a positioning function, which in particular with the use of curved needles not only carries out a defined positioning transversely to the instrument axis, but also a defined positioning of the curve arrangement to the instrument axis. Although the needle holder described in this document is favorably designed with repect to its positioning characteristic, it is not with regard to the tool arrangement, since the needle for the purpose of gripping is to be inserted into a tube relief. Thus with this needle holder one can only operate close to the object in a limited manner, which in practice entails certain disadvantages. Also this needle holder can only be used for holding needles, other gripping procedures such as can be effected with the needle holder known from DE 41 27 812 C2 may thus not be carried out due to design restrictions.
Different from open operations, with endoscopic operations a change of instrument is often complicated, in particular when the body cavity in which the operation is carried out is subject to pressure means. With this aspect in mind a needle holder offered by the company Lawton medical technology represents an improvement in which the needle holder is combined with a ligature scissors. Such a combined instrument is principly advantageous since at least on setting the individual head stitches after forming the knot the ligature must be cut in order to set a further individual head stitch.
In practice however problems may arise when the needle is not grasped as intended with the needle holder located at the distal end, but a piece slips further proximally and gets into the region of the ligature scissors. Since the lever effect in the region of the scissors is usually larger than in the region of the holder, this slipping of the needle or of the needle holder leads regularly to lasting damage on at least one blade of the ligature scissors. With lasting damage however as a rule even during the operation the instrument must be exchanged, since otherwise a severing of the ligature is not possible. In any case a subsequent grinding or even the replacement of the tool is necessary, which is complicated and expensive.